Opening the bladder for cesarean hysterectomy for placenta previa percreta with bladder invasion

Shigeki Matsubara1, Akihide Ohkuchi, Masahiro Yashi

  • 1Department of Obstetrics and Gynecology, Jichi Medical University, Yakushiji Shimotsuke, Tochigi, Japan. matsushi@jichi.ac.jp

Cesarean hysterectomy for placenta previa percreta with bladder invasion often induces not only massive hemorrhage but also severe bladder/ureter injuries. A 37-year-old woman with previous cesarean delivery suffered placenta previa percreta with bladder invasion. At the 34th week, we performed cesarean hysterectomy. Without separating the bladder from the uterus/cervix, we incised the bladder lateral wall using an automatic stapling/cutting device, leaving the bladder posterior wall adhering to the uterus and resecting it with the uterus. The bladder was easily repaired without urological sequelae. We suggest a new, simple and safe technique for cesarean hysterectomy for this disease.

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